Brain Abscess: Causes, Symptoms, Treatment, Prognosis
What is Brain Abscess?
Brain Abscess is a pathological condition in which there is an abscess formation within the brain as a result of a bacterial, fungal, or a viral infection. This infection may have started in the brain due a head injury resulting in an open wound which may have got contaminated or as a result of an infection somewhere else in the body that may have spread to the brain. Studies suggest that majority of the cases of Brain Abscess are caused due to an infection spreading to the brain from other parts of the body.
Among the most frequent locations from where an infection can quickly spread to the brain are the heart and lungs, although an ear or a sinus infection may also cause Brain Abscess. Brain Abscess is an emergent medical condition and needs to be treated right away and any delay in treatment may lead to potentially serious complications like a ruptured abscess which may be life threatening and may cause some serious damage to the brain due to the swelling caused by the Brain Abscess.
What Causes Brain Abscess?
The main cause of a Brain Abscess is bacterial infection, although fungal and viral infections may also cause Brain Abscess. Fungal Brain Abscess normally occurs in people who have a weakened immune system or are above 75 years of age. As stated, lung and heart infections in majority of the cases predispose an individual to developing as Brain Abscess. As a result of the infection, there is swelling of the brain from pus collection and debris from the dead cells that form due to the infection.
What are the Risk Factors for Brain Abscess?
Brain Abscess is a condition that can occur in anyone but there are certain risk factors which predispose an individual to Brain Abscess. These risk factors are:
- Individuals with a compromised immune system are at greater risk for developing brain abscess. People with HIV and AIDS, or the elderly population which due to age have a weak immune system and are prone to frequent infections
- People suffering from medical conditions like cancer or other chronic illnesses especially of the lungs or heart are also at high risk for developing a Brain Abscess
- People with congenital heart disease are also at risk for developing Brain Abscess
- An individual who has had a major head injury as a result of a motor vehicle crash or an assault is also at risk for developing Brain Abscess
- People who have meningitis are also at risk for developing Brain Abscess
- People who are on immunosuppressant medications which weaken the immune system like those undergoing chemotherapy are also at risk.
- People with certain birth defects.
What are the Symptoms of Brain Abscess?
The symptoms of Brain Abscess start to present themselves gradually over a period of a few weeks and include:
- Difficulty with mental processing
- Decreased responsiveness
- Diminishing speech
- Reduced sensation
- Difficulty with movement
- Visual disturbances
- Personality or behavioral changes
- Fever and chills.
Brain Abscess may also occur in babies and infants and the symptoms displayed by them are quite different from those displayed by adults. These symptoms are:
- Projectile vomiting
- Intense crying episodes
- Extremity spasticity.
How is Brain Abscess Diagnosed?
As many of the symptoms of Brain Abscess are quite similar to that of other illnesses, hence it becomes very important to consult with a physician right away after noticing even a single sign of the symptoms mentioned above, especially if the patient has had a recent head injury, has had an infection of the lungs or heart, or has a heart defect.
The physician may do a neurological exam and may also check for any increased pressure in the brain which may be present due to the swelling. Advanced imaging studies like CT or an MRI scan of the brain will also be done and will clearly show areas of swelling which when corroborated with the symptoms and the history of the patient will confirm the diagnosis of Brain Abscess.
How is Brain Abscess Treated?
As stated, Brain Abscess is an emergent medical condition and needs to be treated immediately. The patient will be immediately admitted to the hospital for treatment as increased pressure in the brain may lead to reduced blood flow to the brain causing permanent brain damage. Hence, the first thing in the line of treatment is to reduce the pressure from the brain.
For this, the dimensions of the abscess will have to be determined. In case if the Brain Abscess is small and less than 2.5 cm in diameter broad spectrum antibiotics will be utilized to eliminate the offending bacteria and treat the infection that is causing Brain Abscess. The next step towards treatment is surgery.
Surgery is done in cases if the brain abscess is quite large or if the abscess is not resolving with broad spectrum antibiotics. The surgical procedure involves opening the skull and draining the abscess. The fluid removed is sent for laboratory for analysis. Surgery is reserved for individuals with acute case of Brain Abscess or in individuals in which the Brain Abscess is big enough to pose a risk of rupture within the brain itself.
Can Brain Abscess Be Prevented?
Preventing Brain Abscess is difficult but not impossible. The risk for having a Brain Abscess can significantly be lowered if appropriate and timely treatment is given for people with serious head injuries where they have an open wound to the skull. Treating lung and heart infections or in fact any infection appropriately and following the physician's instructions diligently can also prevent an individual from ending up having Brain Abscess.
In cases of a congenital heart defect, it is best advised to speak to a physician before undergoing any sort of dental or other procedures so that appropriate antibiotics may be prescribed before the procedure to prevent any remote chances of a Brain Abscess.